Medical History: A woman aged 35 years presented with a 3-year history of an asymptomatic plaque of alopecia of cicatricial appearance on her scalp (Fig. A). She was treated with 0.5% clobetasol propionate foam twice a day for 2 months prior to consultation, with no improvement. Physical Examination: The examination of the interparietal region revealed a plaque with hairs of distinct sizes and skin that was difficult to pinch into a fold.
Dermoscopy showed hairs curved around their longitudinal axis, known as comma hairs and corkscrew hairs (Fig. B). Skin biopsy and culture were performed because of the longstanding nature of the lesions and to exclude systemic causes of alopecia; our differential diagnosis included tinea capitis, chronic discoid lupus lesions, lichen planopilaris, and trichotillomania. The culture was positive for Trichophyton rubrum, and histopathology revealed the…
